Click here to read about changes in methods between the 2001-05 and 2003-07 analyses. The study population includes beneficiaries with one of nine chronic conditions who were enrolled in traditional (fee-for-service) Medicare and died during the measurement period. To allow for two years of follow-back for all patients, the population is restricted to those whose age on the date of death was 67 to 99 years, and to those having full Part A and Part B entitlement throughout the last two years of life. Persons enrolled in managed care organizations were excluded from the analysis. For the hospital-specific analyses, patients had to be hospitalized for chronic illness at least once during their last two years of life to be included. For regional analyses, all patients diagnosed with a chronic illness were included.

NUMERATOR DEFINITION:

Any days spent in hospital during terminal hospitalization (discharge status=’B’ in MedPAR file). ICU days are determined by the following indicators in the MedPAR claim: ICARECNT (intensive care day count), CRNRYDAY (coronary care day count).

ADJUSTMENTS:

Rates are adjusted for age, sex, race, primary chronic condition, and the presence of more than one chronic condition using ordinary least squares regression.

The Dartmouth Atlas of Health Care is based at The Dartmouth Institute for Health
Policy and Clinical Practice and is supported by a coalition of funders led by the Robert Wood Johnson Foundation,
including the WellPoint Foundation, the United Health Foundation, the California HealthCare Foundation, and the Charles H. Hood Foundation.